Psychological burden and burnout among regional healthcare providers communicating hereditary tumor findings: A multi-institutional communication skills training implementation study.

Abstract

9020 Background: Psychological burden among healthcare providers in precision oncology affects workforce sustainability. In regional settings with limited genetic counseling resources, providers face compounded stress disclosing hereditary tumor findings to cancer patients. This implementation study, supported by an MSD Medical Education Grant for advancing genetic medicine understanding in biomarker-based precision oncology, assessed structured communication skills training to address provider psychological burden. Methods: We deployed a standardized curriculum across seven regional hospitals in Yamagata Prefecture, Japan, in 2025, integrating SHARE protocol training (Fujimori et al., JCO. 2014) with modules on BRCA testing, microsatellite instability, and genomic profiling disclosure. Implementation strategies included professional actors experienced in medical scenarios, facilitated role-playing, and videotaped quality monitoring. This single-arm pre-post intervention study used a mixed-methods evaluation with questionnaire surveys and qualitative inquiries with a modified grounded theory through an inductive thematic analysis until theoretical saturation. Results: Among 263 participants (median experience 10 years, range 0-36), including physicians, nurses, genetic counselors, pharmacists, and administrative staff, 93% had baseline psychological burden and 92% reported anxiety when communicating hereditary tumor findings. Psychological burden and anxiety post-intervention decreased in 89% (p<0.001) and 84% (p<0.001), respectively, with 89% reporting an improved hereditary tumor understanding (p<0.001). A qualitative analysis of 18 semi-structured interviews revealed five critical themes: persistent institutional barriers to genetic counseling in resource-limited regions, profound emotional exhaustion from simultaneously managing terminal illness and germline implications, role-play enabling authentic skill rehearsal without patient risk, moral distress balancing patient autonomy against family cascade obligations in limited-prognosis contexts, and the critical need for sustained peer support. Conclusions: Multi-site communication skills training including experiential role-play significantly reduced provider psychological burden and anxiety while improving hereditary tumor knowledge across diverse regional healthcare teams. A theory-driven mixed-methods evaluation strengthened intervention rigor. This study supports industry-academic partnerships addressing workforce sustainability while advancing genomic medicine equity in underserved settings. National dissemination with sustained outcome assessment will establish this model as a scalable framework addressing the global workforce crisis in precision oncology.